Howard L. Pierce

 Howard founded Pierce LLC to seek optimal outcomes for clients at sensible, appropriate costs. Howard holds a “Distinguished-High Ethical Standing” rating from Martindale-Hubble, and has been named a Connecticut Super Lawyer-Healthcare Law.  He counsels both healthcare and property/casualty insurers in cases involving a variety of provider claim overpayment matters throughout the United States. He represents some of the largest healthcare payers, self-funded organizations, stop loss carriers, Taft Hartley Benefit Funds and property/casualty insurers in healthcare provider overpayment cost-containment matters. His practice over the last two decades has involved sophisticated investigations that have been conducted outside the formal process of civil discovery, and the effective use of technologically advanced, automated data assembly and analysis. He has negotiated a number of eight-figure settlements with national healthcare providers, both public and non-public. He also represents whistle-blowers in provider healthcare qui tam/False Claim Act lawsuits as well those with information about federal tax fraud and tax underpayments who may be entitled to a reward from the Internal Revenue Service. Howard’s anti-fraud efforts and unique approach were featured on 60 Minutes.   

Howard spent 16 years as a federal agent, the last 10 of which were as a supervisory investigator with the Office of Inspector General, United States Department of Health and Human Services (recipient of Special Achievement Award from the United States Department of Justice). He then went on to create and lead the group health claims deterrents and detection component of The Hartford Life Insurance Company (Corporate Quality Award Recipient) and was also a corporate officer and Corporate Director of Investigations at Phoenix Mutual Life Insurance Company. He was outside litigation counsel for MetraHealth Medicare DMERC Region A, Fraud and Abuse Unit (1993-1995). He was general counsel for the New England Anti-Fraud Association (1994-2014).His anti-fraud matters have involved psychiatric hospitals, national and regional hospital chains, homecare providers, mail order pharmacies, clinical laboratories, national dialysis providers, national medical groups and regional dental groups. He represents property/casualty insurers in state-based investigations against medical providers, national medical equipment manufacturers and distributors and others. He has also represented payers in individual cases involving questionable activity by regional or small/health care provider groups. He works closely with prosecutors and investigators around the country in pursuing criminal penalties for fraudulent providers and others committing fraud and has successfully represented defrauded insurance companies at sentencing under the Mandatory Victims Restitution Act (18 U.S.C. § 3663A). Howard is a retired United States Army Infantry Officer who also served as an enlisted member of the United States Marine Corps. Outside of work, Howard enjoys spending time with his family and their golden, River. 

Representative Matters

• Health Insurance Companies
  • Represented a group of national health care third-party payers in mediation and favorable resolution of claims for overpayment to health care providers involving claim payments in excess of $1,700,000,000.
  • Represented a group of national health care third-party payers in mediation and favorable resolution of claims for overpayment to health care providers involving claim payments in excess of $1,840,000,000.
• Federal Action for Claim Fraud
  • Represented a group of national health care third party payers, as plaintiffs, against a hospital chain, involving claim fraud. Achieved a favorable settlement after defeating motion to dismiss.
• Property and Casualty Insurance Companies
  • Represented a group of property and casualty insurance companies in mediation and favorable resolution of first and third party claim overpayments involving durable medical equipment (DME) claim payments in excess of $6,000,000.
  • Represented a defrauded insurance company at sentencing under the Mandatory Victims Restitution Act of 1996 (18 U.S.C. § 3663A.) effectively employing the statute on behalf of private payer clients, for example –  U.S. v. Richard Fogle, D. Conn, No. 3:06 cr 142 JBA.

  
  

  Education

• Quinnipiac University School of Law, J.D.
• State University of New York at Buffalo, School of Management, B.S.

Admitted to Practice

• Connecticut
• United States District Court, District of Connecticut
• United States District Court, Southern District of New York
• United States District Court, Eastern District of New York
• United States Supreme Court

Teaching

• University of Connecticut School of Law, Trial Practice Instructor, 1996 – 2002

Community Activities

• Anti-Defamation League: Member, Regional Civil Rights Committee, 2007 – 2014
• Congregation Beth Israel: President, 2005 – 2007, Member, Board of Trustees, 1996 – Present
• Leadership Greater Hartford, Member
• National Multiple Sclerosis Corporate Achievers Award recipient, 2000
• Military Officers Association of America, Member

Professional Affiliations

• Connecticut Bar Association (Executive Committee Computer Laws Section, 1991-1994)
• American Bar Association, (Co-Chair, Fraud and Abuse Sub-committee, ABA Health Law Litigation Section, 1992-1994)
• Taxpayers Against Fraud Education Fund, Member
• International Claim Association (Member Fraud and Risk Management Committee)

Publications/Speaking

Howard frequently provides educational seminars to attorneys and those in business and the professions regarding paid claims provider overpayment data mining, and healthcare fraud, abuse and insurance fraud issues.“Fraud and Abuse in Private Insurance Programs”, seminar outline, ABA Section of Litigation, Semi-annual Meeting, Scottsdale, Arizona, November 5, 1992.“A Recent Ruling Enhances Private Healthcare Payers’ Recover Efforts”, Mealey’s Litigation Report Insurance Fraud, Vol. 4 Issue 18, Nov. 1997;“Commercial Payer Provider Overpayment Initiatives”, American Health Lawyers Association, Fraud and Abuse:  Compliance and Enforcement Seminar, November 2, 2000, Washington, D.C.“Under the False Claims Act’s Public Disclosure Bar, Does the Nature of Documents Matter?”  5 ABA Preview of United Supreme Court Cases 38 (2011)

Networking

Connect with Howard on LinkedIn